A97 内科住院医师和员工对胃肠病学轮转的看法

N. K. Klemm, S. Jayakumar
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Results The survey was completed by 18% (30/166) of residents and 20% (13/65) of staff. Most staff (62%) practiced in a community setting. Both cohorts cited overnight cross-coverage consults during (56%) and negative word-of mouth (38%), as reasons they avoided a GI elective. Most participants reported a little (33%) or moderate (47%) amount of GI teaching on medicine service and were unaware of formal lectures (79%) during a GI rotation. Residents and staff were most comfortable managing pancreatitis (98%) and ALF (74%). Staff wished for more experience managing pancreatic and liver masses and outpatient IBD flares; however both groups (86%) were unaware of the ambulatory week during the GI rotation. Conclusions Misperception and unawareness of a GI elective persist amongst internal medicine residents and has implications for new staff managing GI conditions. This study has led to action items that address these concerns. 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引用次数: 0

摘要

摘要 背景 内科住院医师对亚专科的选择部分受其服务经验的影响。内科与急诊量大、程序繁重的胃肠病学(GI)服务之间存在挑战。负面看法可能会限制通过消化内科选修课轮转的住院医师人数,影响他们对常见消化内科疾病的了解和管理舒适度。目的 找出对一家三级医院消化内科服务的误解,并评估住院医师和新员工在处理常见消化内科疾病时的舒适度。方法 对 2022-2023 年期间的内科住院医师进行 20 个问题的调查,对 2020-2022 年期间完成培训的员工进行 13 个问题的调查;调查均采用 Qualtrics 软件匿名进行。结果 18%的住院医师(30/166)和 20%的员工(13/65)完成了调查。大多数员工(62%)在社区环境中工作。两组人都认为,隔夜交叉会诊(56%)和负面口碑(38%)是他们避免选择消化内科手术的原因。大多数参与者表示,他们在医疗服务中接受了少量(33%)或中等量(47%)的消化内科教学,但并不知道在消化内科轮转期间有正式讲座(79%)。住院医师和员工在处理胰腺炎(98%)和 ALF(74%)时最得心应手。工作人员希望获得更多管理胰腺和肝脏肿块以及门诊 IBD 复发的经验;但两组人员(86%)都不知道在消化科轮转期间有门诊周。结论 内科住院医师对消化内科选修课的误解和不了解依然存在,这对管理消化内科疾病的新员工有一定影响。本研究提出了解决这些问题的行动项目。表 1:住院医师和医务人员的认识、表 1:住院医师和医务人员对消化内科的认识、看法和知识 住院医师 医务人员 不完成消化内科轮转的原因 n=30 (%) n=9 (%) 我有足够的经验在一夜之间完成消化内科会诊,作为交叉15 (50) 7 (78) 消化内科服务白天太忙 10 (33) 1 (11) 我听其他住院医师说这不是一个好的轮转 10 (33) 5 (56) 我在内科服务时没有很好的消化内科经验 7 (23) 2 (22) 了解门诊周 n=30 (%) n=12 (%) 否 25 (83) 11(92) 了解正式讲座 n=30 (%) n=12 (%) 否 24 (80) 9 (75) 内科服务期间消化道疾病的教学数量 n=30 (%) n=13 (%) 完全没有 2 (7) 0 少量 12 (40) 2 (15) 适量 10 (33) 10 (77) 大量 6 (20) 0 非常多 0 1 (8) 在我作为员工的第一年、我觉得住院医师培训使我能够处理以下消化道问题 n=13 (%) ALF 或 ACLF 11 (84) 肝包块 5 (38) IBD 爆发--住院病人 3 (23) IBD 爆发--门诊病人 0 胰腺包块 6 (46) 胰腺炎及并发症 11 (84) 资助机构 无
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A97 INTERNAL MEDICINE RESIDENT AND STAFF PERCEPTIONS OF GASTROENTEROLOGY ROTATION
Abstract Background The choice of subspecialty by internal medicine residents is partially influenced by their experience with that service. Challenges exist between internal medicine and the high acuity, procedurally-heavy, gastroenterology (GI) service. Negative perceptions may limit the number of residents rotating through a gastroenterology elective, impacting knowledge and comfort managing common GI conditions. Aims To identify misperceptions of the GI service at a tertiary hospital, and evaluate resident and new staff comfort in managing common GI conditions. Methods Twenty-question survey sent to internal medicine residents during 2022-2023 and 13-question survey sent to staff that completed training from 2020-2022; both anonymous, and using Qualtrics software. Results The survey was completed by 18% (30/166) of residents and 20% (13/65) of staff. Most staff (62%) practiced in a community setting. Both cohorts cited overnight cross-coverage consults during (56%) and negative word-of mouth (38%), as reasons they avoided a GI elective. Most participants reported a little (33%) or moderate (47%) amount of GI teaching on medicine service and were unaware of formal lectures (79%) during a GI rotation. Residents and staff were most comfortable managing pancreatitis (98%) and ALF (74%). Staff wished for more experience managing pancreatic and liver masses and outpatient IBD flares; however both groups (86%) were unaware of the ambulatory week during the GI rotation. Conclusions Misperception and unawareness of a GI elective persist amongst internal medicine residents and has implications for new staff managing GI conditions. This study has led to action items that address these concerns. Table 1: Resident & staff awareness, perceptions & knowledge of GI Resident Staff Reasons for not completing a GI rotation n=30 (%) n=9 (%) I had adequate experience completing GI consults overnight as Cross-Coverage 15 (50) 7 (78) GI service was too busy during the day 10 (33) 1 (11) I heard from other residents that is was not a good rotation 10 (33) 5 (56) I had not had a good experience with GI when on medicine service 7 (23) 2 (22) Aware of ambulatory week n=30 (%) n=12 (%) No 25 (83) 11 (92) Aware of formal lectures n=30 (%) n=12 (%) No 24 (80) 9 (75) Amount of teaching on GI conditions during medicine service n=30 (%) n=13 (%) None at all 2 (7) 0 A little 12 (40) 2 (15) A moderate amount 10 (33) 10 (77) A lot 6 (20) 0 A great deal 0 1 (8) During my first year as staff, I felt residency prepared me to manage the following GI issues n=13 (%) ALF or ACLF 11 (84) Liver Mass 5 (38) IBD flare - inpatient 3 (23) IBD flare - outpatient 0 Pancreatic mass 6 (46) Pancreatitis & complications 11 (84) Funding Agencies None
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